Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 24;16(3):e0248826.
doi: 10.1371/journal.pone.0248826. eCollection 2021.

Implementation strategies in emergency management of children: A scoping review

Alex Aregbesola  1   2 , Ahmed M Abou-Setta  3   4 , George N Okoli  3 , Maya M Jeyaraman  3   4 , Otto Lam  3 , Viraj Kasireddy  3 , Leslie Copstein  3 , Nicole Askin  5 , Kathryn M Sibley  3   4 , Terry P Klassen  1   2   3   4
Affiliations

Implementation strategies in emergency management of children: A scoping review

Alex Aregbesola et al. PLoS One. .

Abstract

Background: Implementation strategies are vital for the uptake of evidence to improve health, healthcare delivery, and decision-making. Medical or mental emergencies may be life-threatening, especially in children, due to their unique physiological needs when presenting in the emergency departments (EDs). Thus, practice change in EDs attending to children requires evidence-informed considerations regarding the best approaches to implementing research evidence. We aimed to identify and map the characteristics of implementation strategies used in the emergency management of children.

Methods: We conducted a scoping review using Arksey and O'Malley's framework. We searched four databases [Medline (Ovid), Embase (Ovid), Cochrane Central (Wiley) and CINAHL (Ebsco)] from inception to May 2019, for implementation studies in children (≤21 years) in emergency settings. Two pairs of reviewers independently selected studies for inclusion and extracted the data. We performed a descriptive analysis of the included studies.

Results: We included 87 studies from a total of 9,607 retrieved citations. Most of the studies were before and after study design (n = 68, 61%) conducted in North America (n = 63, 70%); less than one-tenth of the included studies (n = 7, 8%) were randomized controlled trials (RCTs). About one-third of the included studies used a single strategy to improve the uptake of research evidence. Dissemination strategies were more commonly utilized (n = 77, 89%) compared to other implementation strategies; process (n = 47, 54%), integration (n = 49, 56%), and capacity building and scale-up strategies (n = 13, 15%). Studies that adopted capacity building and scale-up as part of the strategies were most effective (100%) compared to dissemination (90%), process (88%) and integration (85%).

Conclusions: Studies on implementation strategies in emergency management of children have mostly been non-randomized studies. This review suggests that 'dissemination' is the most common strategy used, and 'capacity building and scale-up' are the most effective strategies. Higher-quality evidence from randomized-controlled trials is needed to accurately assess the effectiveness of implementation strategies in emergency management of children.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Summary of literature search and screening process.
Fig 2
Fig 2. Number (%) of included studies by the type of implementation strategy.
See this image and copyright information in PMC

References

    1. Emergency Medical Services for Children—NPRP. Ensuring Pediatric Readiness for All Emergency Department. EMSC—NPRP 2017.
    1. Canadian Institute for Health Information. Sources of Potentially Avoidable Emergency Department Visits. Ottawa, ON. CIHI 2014;ISBN 978-1-77109-320-0.
    1. American Academy of Pediatrics Committee on Pediatric Emergency Medicine, Yamamoto LG. Access to optimal emergency care for children. Pediatrics 2007. January;119(1):161–164. 10.1542/peds.2006-2900 - DOI - PubMed
    1. Proctor EK, Powell BJ, McMillen JC. Implementation strategies: recommendations for specifying and reporting. Implement Sci. 2013;8:139. 10.1186/1748-5908-8-139 - DOI - PMC - PubMed
    1. Leeman J, Birken SA, Powell BJ, Rohweder C, Shea CM. Beyond "implementation strategies": classifying the full range of strategies used in implementation science and practice. Implement Sci. 2017;12(1): 017–0657. 10.1186/s13012-017-0657-x - DOI - PMC - PubMed

Publication types

LinkOut - more resources